Masimo was founded in 1989 by electrical engineer Joe Kiani, who was later joined by fellow engineer Mohamed Diab.[2]
Masimo went public in 2007[3] and is currently traded on the Nasdaq stock exchange under the symbol MASI. In 2011, Forbes named Masimo to its list of top 20 public companies under a billion dollars in revenue.[4][5]
In October 2023, the United States International Trade Commission (ITC) ruled that Apple Inc. had infringed upon patents for light-based pulse oximetry owned by Masimo in its Apple Watch product line. Masimo accused Apple of poaching engineers from the company after it declined offers to partner with or be acquired by Apple. Apple denied these claims, stating that it had discussed partnerships with several vendors, and declined to work with Masimo because it was not in the consumer market.[7][8]
In September 2024, founder and CEO Joe Kiani resigned as CEO following results of a proxy battle.[9][10]
Technology
Signal Extraction Technology (SET) pulse oximetry
Pulse oximetry uses two light emitting diodes (LEDs), one red and one infrared, to measure the absorption of light and translates that into the percentage of hemoglobin molecules that are bound to oxygen, which is called arterialoxygen saturation (SpO2). Conventional pulse oximetry assumes that arterial blood is the only blood moving (pulsating) in the measurement site. However, during patient motion, the venous blood also moves, which can cause conventional pulse oximetry to under-read SpO2 levels because it cannot distinguish between the arterial and venous blood.[11][12]
SET identifies the venous blood signal (which has a lower oxygen saturation level than arterial blood), isolates it, and uses adaptive filters to extract the arterial signal in order to report accurate SpO2 and pulse rate. In addition, SET pulse oximetry provides perfusion index (PI) and pleth variability index (PVI). Multiple studies have shown that compared to non-SET pulse oximeters, SET increases the ability to detect life-threatening events and reduces false alarms.[13][14] Additional studies have also shown the impact of SET on patient outcomes, such as helping clinicians:
Increase detection of critical congenital heart disease (CCHD) in newborns[17]
Reduce ventilator weaning time by titrating FiO2 faster and reduce arterial blood gas measurements in the Intensive Care Unit (ICU)[18]
Decrease rapid response activations and Intensive Care Unit (ICU) transfers through earlier identification of patients in distress through low SpO2 and abnormal pulse rate measurements[19][20]
Decrease fluid administered during surgery and reduce patient risk[21]
In 2011, the American Academy of Pediatrics and the U.S. Department of Health and Human Services recommended mandatory screening for all newborns, using "motion-tolerant pulse oximeters that report functional oxygen saturation have been validated in low perfusion conditions".[22] To make this recommendation, the CCHD workgroup relied on two independent studies that exclusively used SET pulse oximetry to assess newborns. In 2012, Masimo received FDA 510(k) clearance for devices and sensors with labeling for screening newborns for CCHD. It marked the first time the FDA cleared specific labeling indicating the use of pulse oximeters, in conjunction with a physical examination, to screen newborns for CCHD.[23]
In 2012, the National Health Service (NHS) Technology Adoption Centre in the United Kingdom advised hospitals to use Intraoperative Fluid Management, and included Masimo's PVI among technologies available for helping clinicians manage fluid during surgeries.[24] In 2013, the French Society for Anaesthesia and Intensive Care (SFAR) added PVI to its guidelines for optimal hemodynamic management of surgical patients.[25]
Rainbow Pulse CO-Oximetry
Rainbow Pulse CO-Oximetry uses more than seven wavelengths of light to continuously and noninvasively measure hemoglobin (SpHb), carboxyhemoglobin (SpCO), and methemoglobin (SpMet), in addition to oxygen saturation (SpO2), pulse rate, perfusion index (Pi), and pleth variability index (PVi).[26] A study at Massachusetts General Hospital showed that SpHb monitoring helped clinicians decrease the frequency of patients receiving blood transfusions during surgery from 4.5% to 0.6%.[27] Another study from Cairo University showed that SpHb monitoring helped clinicians reduce blood transfusions in high blood loss surgery by an average of 0.9 units per patient.[28] A study at CHU Limoges [fr] in France found that monitoring with SpHb and PVi, integrated into a hospital-wide fluid and blood administration protocol, was associated with earlier transfusion and reduced mortality at 30 and 90 days by 33% and 29%, respectively.[29]Emergency department studies have shown that SpCO helps clinicians increase the detection of carbon monoxide (CO) poisoning and decreases the time to treatment compared to invasive methods.[30][31][32] The Pronto-7 device for noninvasive spot checking of hemoglobin, along with SpO2 and pulse rate, has been recognized with a gold Medical Design Excellence Award.[33]The World Health Organization called noninvasive hemoglobin an "innovative medical technology for cost-effectively addressing global health concerns and needs".[34]
In October 2014, Masimo announced CE Marking of Oxygen Reserve Index or ORi, the company's 11th noninvasive parameter, which provides real-time visibility to oxygenation status. ORi is intended to supplement, not replace, oxygen saturation (SpO2) monitoring and partial pressure of oxygen (PaO2) measurements. ORi can be trended and has optional alarms to notify clinicians of changes in a patient's oxygen reserve, and may enable proactive interventions to avoid hypoxia and unintended hyperoxia.[citation needed]
Patient and consumer monitoring
SafetyNet
Patient SafetyNet is a remote monitoring and notification system designed for patients on medical/surgical care floors.[35] A large study by Dartmouth-Hitchcock Medical Center showed Patient SafetyNet helped clinicians achieve a 65% reduction in distress codes and rescue activations and a 48% decrease in patient transfers to intensive care units (ICU), yielding a savings of 135 Intensive Care Unit (ICU) days annually for an annual opportunity-cost savings of $1.48 million.[36][37]
In 2020, Dartmouth-Hitchcock published a retrospective study showing that over ten years of using Patient SafetyNet, there were zero patient deaths and no patients were harmed by opioid-induced respiratory depression while continuous monitoring with Masimo SET was in use.[38]ECRI Institute gave Dartmouth its Health Devices Achievement Award for its use of Patient SafetyNet to prevent "severe patient harm".[39] Masimo has introduced Halo ION in the Patient SafetyNet system, combining multiple physiologic parameters into one number to help clinicians assess overall patient status.[40]
In 2010, Masimo began offering brain function monitoring to measure the effects of anesthesia and sedation by monitoring both sides of the brain's electrical activity (EEG). Studies have shown this results in more individualized titration and improved care.[45]
In June 2020, the company released Bridge, a medical device intended to reduce symptoms of opioid withdrawal via neuromodulation.[48]
In April 2023, the company received FDA approval for a pulse oximetry-based device for preventing opioid overdose by providing alerts of respiratory depression. The device—which was the subject of an innovation challenge issued by the FDA—received a De Novo classification allowing it to be distributed over-the-counter and through prescription[49]
Smartwatches
In 2022, Masimo released the W1, a smartwatch that includes continuous health monitoring features and integrated with Masimo's other product lines. It was released in a limited public launch in the U.S., and to telehealth providers internationally.[50]
^Bizzarro, M; Ly, F; Katz, K; Shabanova, V; Ehrenkranz, R; Bhandari, V (2013). "Temporal quantification of oxygen saturation ranges: an effort to reduce hyperoxia in the neonatal intensive care unit". J Perinatol. 34 (1): 33–8. doi:10.1038/jp.2013.122. PMID24071904. S2CID7240789.
^Durbin, CG; Rostow, SK (2002). "More reliable oximetry reduces the frequency of arterial blood gas analysis and hastens oxygen weaning following cardiac surgery; a prospective randomize trial of the clinical impact of a new technology". Crit Care Med. 30 (8): 1735–40. doi:10.1097/00003246-200208000-00010. PMID12163785. S2CID10226994.
^Awada, WNFM; Maher, F (2013). "Reduction in red blood cell transfusions during neurosurgery with noninvasive and continuous hemoglobin monitoring". p. 51.
^Cros, Jérôme; Dalmay, François; Yonnet, Sandra; Charpentier, Matthieu; Tran-Van-Ho, Jessica; Renaudeau, François; Drouet, Anais; Guilbaut, Pierre; Marin, Benoit; Nathan, Nathalie (2019-08-03). "Continuous hemoglobin and plethysmography variability index monitoring can modify blood transfusion practice and is associated with lower mortality". Journal of Clinical Monitoring and Computing. 34 (4): 683–691. doi:10.1007/s10877-019-00367-z. ISSN1573-2614. PMID31376030. S2CID199389128.
^Suner, S; Partridge, R; Sucov, A; Valente, J; Chee, K; Hughes, A; Jay, G (2008). "Non-invasive pulse co-oximetry screening in the emergency department identifies occult carbon monoxide toxicity". J Emerg Med. 34 (4): 441–50. doi:10.1016/j.jemermed.2007.12.004. PMID18226877.
^Hampson, N (2012). "Noninvasive pulse co-oximetry expedites evaluation and management of patients with carbon monoxide poisoning". Am J Emerg Med. 30 (9): 2021–4. doi:10.1016/j.ajem.2012.03.026. PMID22626815.
